U.S. blacks, gay and straight, have biggest struggle with HIV

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Hospitals for Poor May Struggle Further Under Health Care Reform

HealthDay – 2 hrs 1 min ago TUESDAY, July 17 (HealthDay News) -- A new study finds that so-called "safety-net" hospitals that serve the poor do a worse job overall than other hospitals, a potentially big problem as health care reform boosts the number of people who have insurance and more choice about where they can go for care.

Medicare used to give these hospitals extra payments for taking care of poor people. But under health care reform, they'll get less of that funding and more for how they perform on a variety of measurements, including how patients rate them.

"Our results suggest that safety-net hospitals are struggling on this important metric. As a result, safety-net hospitals are likely to get penalized under the new payment scheme," said Paula Chatterjee, a medical student at Harvard School of Public Health. "Given that safety-net hospitals are already financially stretched, even small losses can be potentially devastating for these hospitals."

At issue are hospitals that serve poor people, often including those who don't have health insurance. According to the study, they tend to be sicker than other patients and have less trust in the health care system.

Under health care reform, the federal government punishes hospitals that perform poorly on a variety of measures by not giving them some Medicare payments.

The researchers studied 3,096 hospitals and examined answers that patients gave to surveys about their experiences at the hospitals. The safety-net hospitals -- 769 of the total -- were slightly less likely than other hospitals to be in urban areas (many are in rural parts of the country), much more likely to serve Medicaid patients and more likely to have fewer nurses per patient.

The safety-net hospitals had the lowest overall rating among patients and ranked a bit lower in the patient perception of things such as communication with medical staff and management of their condition.

"Safety-net hospitals are a critical part of our health care system. They provide care to everyone, irrespective of the patient's ability to pay. The new payment scheme, which ties part of the hospital payments to how those hospitals do on patient-reported scores, is laudable in its goals," Chatterjee said. "Our paper says that under the new scheme, safety-net hospitals are likely to do poorly. We need new strategies to help these hospitals improve."

What could be done? Chatterjee said Medicare should work with hospitals to help them do a better job of caring for patients. "Given the challenges of caring for a relatively poor population and the low reimbursement rates, we suspect that many hospitals have not been able to focus on optimizing patient experience," she said. "It's time to help these hospitals do so."

In a commentary, Dr. Katherine Neuhausen, a physician at the University of California, Los Angeles, and Dr. Mitchell Katz, director of the Los Angeles County Department of Health Services, wrote that the federal government should try to help the hospitals instead of adding pressure. One way to do that, they write, is to give more money to the hospitals that perform well instead of penalizing those that don't.

The study appeared online July 16 in the Archives of Internal Medicine.

More information

To compare the quality of hospitals, try the federal government's Hospital Compare website.

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Many Hospitalized Kids Struggle With Pain

HealthDay – Fri, Jul 6, 2012 FRIDAY, July 6 (HealthDay News) -- Many children who are hospitalized suffer from moderate to severe pain despite advances in medicine's understanding of how pain works and the best ways to treat it, a new study finds.

The research is based on medical records and, in some cases, surveys of 199 patients treated at Johns Hopkins Children's Center in 2007 and 2008. Almost nine out of every 10 children experienced pain, and it was moderate to severe for 40 percent of them. In some cases, children still had pain despite treatment.

"This study was designed as a pulse check to gauge our own progress," lead investigator Lori Kozlowksi, a pediatric pain specialist at Hopkins Children's Center, said in a Hopkins news release. "Our verdict is that while we've made tremendous strides, there's still work to be done."

According to the news release, previous research has found that people who are exposed to intense pain as children can become more sensitive to pain as adults. Pain can also lead to a variety of health problems, especially if it's not treated properly.

"Pain is the fifth vital sign which, together with blood pressure, heart rate, breathing and temperature, can provide important clues about a patient's well-being," senior investigator Dr. Constance Monitto, a pediatric anesthesiologist at Johns Hopkins Children's Center, said in the news release. "Treating a child in pain is a fundamental responsibility of every physician and nurse."

The researchers also found that kids who undergo surgery experience more pain than those who don't, and it's more challenging to relieve pain in cancer patients. Girls are more vulnerable than boys to pain, and many of those who were prescribed opioid painkillers "as needed" never actually got any.

The study was recently published online in the journal Pain Management Nursing.

More information

For more on pain management in children, go to Stanford School of Medicine.

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An Eating Plan For Weight Loss – End The Struggle

Weight Loss! Trying to Lose Weight ? Have you been trying to lose weight? Losing weight quickly can seem a daunting task to most, a lot of people out there are looking for the miracle solution, but i can tell you now that that does not exist... the only way you will achieve the results you strive… By: Joanna Bloggs in  Health and Fitness  >  Weight Loss   Feb 29, 2012   0   Likes: 0

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Analysis: HMO stocks may struggle over health claim costs

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